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Found 11764 cases where Vaccine is PNC13

Case Details (Reverse Sorted by Appearance Date)

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VAERS ID:554878 (history)  Vaccinated:2014-10-23
Age:0.2  Onset:2014-10-31, Days after vaccination: 8
Gender:Female  Submitted:0000-00-00
Location:North Carolina  Entered:2014-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ranitidine
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC4550AA0IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH866800IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.K0091820PO 
Administered by: Private     Purchased by: Private
Symptoms: Infantile spitting up, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Neonatal disorders (narrow)
Write-up: Sick office visit 11-1-14. Vaccines - PENTACEL, ROTATEQ, PREVNAR given 10-23-14. Patient projectile vomited 2x 10-31-14. both times soon after eating. Spitting up since then but not more then usual. Happy, not fussy. No fever.

VAERS ID:551921 (history)  Vaccinated:2014-10-27
Age:0.1  Onset:2014-10-28, Days after vaccination: 1
Gender:Male  Submitted:2014-11-05, Days after onset: 8
Location:Maryland  Entered:2014-11-05
Life Threatening? No
Died? Yes
   Date died: 2014-10-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: US2014GSK016547
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSS232P52IMLL
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURERSUI062AEA0IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHSJ114840IMRL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CB452A0PO 
Administered by: Private     Purchased by: Other
Symptoms: Death, Epistaxis, Inappropriate schedule of drug administration, Incorrect dose administered, Mouth haemorrhage, Resuscitation
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: This case was reported by a consumer and described the occurrence of death in a 6-week-old male patient who received PEDIARIX (batch number S232P5, expiry date 30th August 2016). Co-suspect products included PEDIARIX (batch number S232P5, expiry date 30th August 2016), PEDIARIX (batch number S232P5, expiry date 30th August 2016), PEDIARIX (batch number S232P5, expiry date 30th August 2016), ROTARIX (batch number A41CB452A, expiry date 31st January 2016) and Hib (batch number SUI062AEA, expiry date 10th October 2015). On 27th October 2014, the patient received the 1st dose of PEDIARIX (unknown) .5 ml, the 2nd dose of PEDIARIX (unknown) .5 ml, the 3rd dose of PEDIARIX (unknown) .5 ml, the 4th dose of PEDIARIX (unknown) .5 ml, the 1st dose of ROTARIX (oral) 1 ml and the 1st dose of Hib (unknown) .5 ml. On 27th October 2014, Not Applicable after receiving PEDIARIX, PEDIARIX, PEDIARIX and ROTARIX and an unknown time after receiving PEDIARIX, the patient experienced overdose, overdose and overdose. On 28th October 2014, the patient experienced death (serious criteria death and GSK medically significant), blood coming out from nose (serious criteria death) and blood coming out from mouth (serious criteria death). On 28th October 2014, the outcome of the death, blood coming out from nose and blood coming out from mouth were fatal. On an unknown date, the outcome of the overdose, overdose and overdose were unknown. The patient died on 28th October 2014. The reported cause of death was unknown cause of death. The reporter considered the death, blood coming out from nose and blood coming out from mouth to be almost certainly related to PEDIARIX, PEDIARIX, PEDIARIX, PEDIARIX and ROTARIX. Additional information received: The reporter was the patient''s maternal grandmother. She reported that her family had dual citizenship. Her daughter gave birth to the child in one country and was planning to return to another country on 30 October 2014. The doctor advised the mother to bring child for immunizations prior to the trip. The patient was growing very well, at 88% growth percentile for his weight and height with no medical concerns, he passed all the tests. The patient was administered all three PEDIARIX shots at the same time on 27 October 2014, in the afternoon, along with ROTARIX and the Sanofi Pasteur flu shot. The mother reported that the baby received 2 shots on his left leg and 2 shots on his right leg, but the doctor stated in his records that the baby got one shot on his left leg and the others in the right leg. The grandmother stated that her daughter returned home with the baby after the doctor visit and the baby slept. When he woke up, she fed him and then put him to bed around 12 midnight or 1am on 28 October 2014. When she woke up around 7 am he was already dead, with blood coming out of his nose and mouth. They called 911 and the baby''s mother tried to resuscitate him, then he was taken to hospital. At the hospital, the family was told he had been dead for a few hours and was formally pronounced death on 28 October 2014. The grandmother was willing to be contacted and the family will seek legal action because they felt the death was caused by the vaccines administered that day.

VAERS ID:551951 (history)  Vaccinated:2014-02-04
Age:0.4  Onset:2014-02-06, Days after vaccination: 2
Gender:Female  Submitted:2014-11-05, Days after onset: 272
Location:Mississippi  Entered:2014-11-05
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
    Extended hospital stay? Yes
Previous Vaccinations: perinasal cyanosis with apnea~Polio Virus, Oral (no brand name)~1~0.17~Patient
Other Medications: Tylenol 160 mg/5mL q6 hours given at time of vaccinations on 2/4/2014 until time of collapse on 2/6/2014
Current Illness: 2 weeks out from Respiratory Syncytial Virus, 4 days out from gastrointestinal virus
Preexisting Conditions: 2 weeks out from Respiratory Syncytial Virus
Diagnostic Lab Data: Glucose: 328; CO2: 14; Anion Gap: 20; WBC: 16,300; Hemaglobin: 10.5; Hematocrit: 30.4; Platelets: 146,000; Urinalysis: 4+ glucose, glucose $g1,000, 15 ketones, + 2-5 WBC''s. Thin small subdural hematoma; Retinal Hemorrhages
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS7449K1IMUN
HIBV: HIB (ACTHIB)SANOFI PASTEURU1003AB1UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH419471UNUN
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.J0109701PO 
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Anion gap, Apnoea, Blood glucose increased, Bradycardia, Bradypnoea, Carbon dioxide decreased, Convulsion, Dehydration, Diabetic ketoacidosis, Endotracheal intubation, Glucose urine present, Haematocrit decreased, Haemoglobin normal, Hyperglycaemia, Ketonuria, Leukocytosis, Mechanical ventilation, Platelet count decreased, Respiratory arrest, Retinal haemorrhage, Subdural haematoma, Thrombocytopenia, Urine ketone body present, White blood cell count normal, White blood cells urine positive
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Arrhythmia related investigations, signs and symptoms (broad), Haemorrhagic cerebrovascular conditions (narrow), Convulsions (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Retinal disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Hypersensitivity (broad)
Write-up: Seizure and subsequent apnea/bradypnea at home at 4:00 pm, bradycardia at 4:10-4-15 PM during transport by EMS to hosptial. Intubated, placed on ventilator and stabilized at primary hospital. Lab findings showed hyperglycemia, ketonuria, Diabetic ketoacidosis, anemia, leukocytosis, thrombocytopenia, dehydration, subdural hematoma. Transported to specialty hospital, weaned off of ventilator. Then suffered additional seizures and respiratory arrest- reintubated. Hospital stay 7 days, currently on anti-seizure medication.

VAERS ID:552091 (history)  Vaccinated:2014-10-03
Age:  Onset:2014-10-05, Days after vaccination: 2
Gender:Male  Submitted:2014-10-08, Days after onset: 3
Location:Connecticut  Entered:2014-11-05, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: Went to E.D. has not yet followed up at our office
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAT57M3IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4978AB1IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.J0154373IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH450973IMLL
Administered by: Public     Purchased by: Unknown
Symptoms: Abasia, Crying, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad)
Write-up: Mother called on-call provider on 10/5/14 - pt had fever, not walking, crying about leg pain. Went to ED.

VAERS ID:552127 (history)  Vaccinated:2014-10-20
Age:0.2  Onset:2014-10-20, Days after vaccination: 0
Gender:Male  Submitted:2014-11-05, Days after onset: 16
Location:Kansas  Entered:2014-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: 1. Hydrocortisone TID - 1.5mg (0600), 1.5mg (1400), and 1.5mg (2200) 2. Levothyroxine 25mcg daily
Current Illness: No
Preexisting Conditions: 1. Neonatal lupus 2. Congenital complete heart block s/p pacemaker 3. Adrenal insufficiency 4. Congenital hypothyroidism 5. Recurrent hypoglycemia secondary to adrenal insufficiency and hyperinsulinemia 6. Persistent mild transaminitis 7. Former 34 week prematurity
Diagnostic Lab Data: Mom had noticed some preprandial hypoglycemia the evening before this clinic visit date and was already planning on contacting endocrine on this date. After hospitalization, it was felt that his hypoglycemia could have been due to hyperinsulinism vs. stress from vaccines. His hydrocortisone dose was adjusted and diazoxide was added for glycemic control. This case is also undergoing a CISA evaluation currently.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSNK9470IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.K0086800IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH862120IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FB452A0PO 
Administered by: Private     Purchased by: Private
Symptoms: Condition aggravated, Hyperinsulinism, Hypoglycaemia, Pyrexia, Stress
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Lipodystrophy (broad)
Write-up: Fever, recurrent preprandial hypoglycemia.

VAERS ID:552242 (history)  Vaccinated:2014-10-26
Age:72.0  Onset:2014-10-28, Days after vaccination: 2
Gender:Female  Submitted:2014-11-05, Days after onset: 8
Location:Connecticut  Entered:2014-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU5003AA IMRA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ900920IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: The patient noticed a red patch on 10/28/14. Little warm, but no itching or pain. Resolved next day.

VAERS ID:554633 (history)  Vaccinated:2014-10-29
Age:28.0  Onset:2014-10-30, Days after vaccination: 1
Gender:Female  Submitted:2014-11-05, Days after onset: 6
Location:Unknown  Entered:2014-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MAXALT; SYNTHROID; PLAQUENIL; Meclizine; Cholecalciferol
Current Illness: Coeliac disease
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1411USA000746
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K009106 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Fatigue, Influenza like illness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: This spontaneous report as received from a nurse refers to a 28 year old female patient with celiac disease. On 29-OCT-2014 the patient was vaccinated with PNEUMOVAX 23 (lot # K009106, expiry date: 25-FEB-2016, route of administration, anatomical location and dose unknown) and PREVNAR 13 (dose, route of administration and anatomical location was unknown). Concomitant therapies included MAXALT, meclizine, SYNTHROID, PLAQUENIL and cholecalciferol (reported as Vitamin D3). Approximately on 30-OCT-2014 (reported as 24 hours later) the patient experienced flu-like symptoms such as lightheadedness and fatigue. No treatment was given for the events. No lab tests were performed. The patient had called the reporter and visited the reporter and sought medical attention. The outcome of flu-like symptoms, fatigue and lightheadness was reported as recovering/resolving. The causality was unknown. No further information was provided. Additional information has been requested.

VAERS ID:554703 (history)  Vaccinated:2014-10-29
Age:57.0  Onset:2014-11-04, Days after vaccination: 6
Gender:Male  Submitted:2014-11-05, Days after onset: 1
Location:Massachusetts  Entered:2014-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ238640IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site discomfort, Injection site erythema, Injection site warmth, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Discomfort in area of injection - rash noticed 5 days post injection 6" x 2". 11/5/14 today area 9" x 3" - red/warm.

VAERS ID:554707 (history)  Vaccinated:2014-11-03
Age:69.0  Onset:2014-11-05, Days after vaccination: 2
Gender:Female  Submitted:2014-11-05, Days after onset: 0
Location:Montana  Entered:2014-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocodone; naproxen; acetaminophen; MUCINEX; vit D and B6
Current Illness: None
Preexisting Conditions: Allergic to molds and pollens; Has fibromyalgia
Diagnostic Lab Data: None
CDC Split Type: VFC136
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ238670SYRLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Pain, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 11/15/14: Pt. called this am to report "big red blobs" on upper arm near shot injection site. C/O only mild soreness. Arm feels a little warm to the touch. No itchiness. Pt feels fine-able to move arm normally. Denies fever. Band aide removed this am by pt

VAERS ID:554733 (history)  Vaccinated:2014-10-02
Age:37.0  Onset:2014-10-03, Days after vaccination: 1
Gender:Male  Submitted:2014-11-04, Days after onset: 32
Location:California  Entered:2014-11-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol; gemfibrozil; lisinopril; LOVAZA
Current Illness: None
Preexisting Conditions: Penicillin
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ900920IMLA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Musculoskeletal stiffness, Neck pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Patient developed a headache 24 hr after vaccine. Neck pain and stiffness occurred 48 hr after vaccine. Pain and stiffness have decreased slowly over time.

VAERS ID:554736 (history)  Vaccinated:2014-10-27
Age:0.1  Onset:2014-10-28, Days after vaccination: 1
Gender:Female  Submitted:2014-11-05, Days after onset: 8
Location:Arizona  Entered:2014-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSJ9MS40UNLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.K0086790UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ498430UNRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.K0064580PO 
Administered by: Private     Purchased by: Private
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient began to vomit after ROTATEQ was given.

VAERS ID:551762 (history)  Vaccinated:0000-00-00
Age:  Onset:0000-00-00
Gender:Male  Submitted:2014-11-03
Location:Unknown  Entered:2014-11-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2014299018
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Deafness
SMQs:, Hearing impairment (narrow)
Write-up: This is a spontaneous report from a contactable physician through a Pfizer Sales Representative. A male patient of unspecified age received PREVNAR 13 on unknown date, at single dose. Medical history and concomitant medications were not reported. The patient experienced hearing loss after he was administered with PREVNAR 13. Event outcome was not provided at the time of report.

VAERS ID:551792 (history)  Vaccinated:2014-10-21
Age:0.5  Onset:2014-10-26, Days after vaccination: 5
Gender:Male  Submitted:2014-10-29, Days after onset: 3
Location:Minnesota  Entered:2014-11-04, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: Electrolytes; Abd X-ray; air enema
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS795AE2IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH866522IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.J0113362PO 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal X-ray, Blood electrolytes, Enema administration, Intussusception, Rectal haemorrhage, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)
Write-up: Presented to ER on 10/26/14 with vomiting. Also passed stool and thickened red blood from return after the stool. No fever air enema was attempted multiple times but were not able to reduce his intussusception. Patient then went to surgery.

VAERS ID:551829 (history)  Vaccinated:2014-10-28
Age:0.5  Onset:2014-11-01, Days after vaccination: 4
Gender:Male  Submitted:2014-11-04, Days after onset: 3
Location:Oklahoma  Entered:2014-11-04
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Yes, bilateral purulent conjunctivitis with no history of fever.
Preexisting Conditions: NKDA or signficant PMH
Diagnostic Lab Data: KUB imaging confirmed distended loops of bowel concerning for intussusception.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSNK9472IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUI104AA2IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH866522IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.K0102192PO 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal distension, Colectomy, Decreased appetite, Enema administration, Faeces discoloured, Haematochezia, Intussusception, Irritability, Surgery, Urinary system x-ray abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Noninfectious diarrhoea (broad)
Write-up: Seen in outpatient clinic 11/3/14 AM with decreased appetite, increased fussiness, emesis, abdominal distension, reddish-black stools worsening over 2 days. On physical exam, distended abdomen with a diaper with currant jelly stool. KUB confirmed intussusception. Sent to ED. Treated initially with air enema, not resolved so had surgery to reduce and partial colocetomy.

VAERS ID:551833 (history)  Vaccinated:2014-10-16
Age:1.3  Onset:2014-10-16, Days after vaccination: 0
Gender:Female  Submitted:2014-11-04, Days after onset: 19
Location:Kentucky  Entered:2014-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, Tylenol Triaminic
Current Illness: N/A
Preexisting Conditions: None
Diagnostic Lab Data: U/A at 1944 on 10/16 at ER
CDC Split Type: KY201407
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4457AA3UNLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH940AC UN 
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG4547C3UNLL
Administered by: Public     Purchased by: Public
Symptoms: Abasia, Abnormal behaviour, Aphasia, Diet refusal, Muscle spasms, Urine analysis
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Mom reported infant would not lay down for a nap would not eat was having muscle spasm. Called MD told to go to ER. Mother states child would not walk or talk.

VAERS ID:551835 (history)  Vaccinated:2014-10-24
Age:79.0  Onset:2014-10-24, Days after vaccination: 0
Gender:Male  Submitted:2014-11-04, Days after onset: 11
Location:Arizona  Entered:2014-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Iodine (shell fish)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR    
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH    
Administered by: Other     Purchased by: Other
Symptoms: Abdominal discomfort, Asthenia, Cough, Diarrhoea, Oropharyngeal pain, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Began with light throat ache and coughing. Around 8 pm, started vomiting. Vomited twice through the night. Also diarrhea. Next day and the following few days, stomach still was upset. First day after I got the shots, felt extremely weak and had to be careful not to fall down. Weakness and stomach upset gradually diminished and as of today, Nov 4, effects are almost gone. Had a similar vomiting reaction each time I had eaten mussels or shrimp, even small amounts, in the past.

VAERS ID:551838 (history)  Vaccinated:2014-11-03
Age:0.6  Onset:2014-11-03, Days after vaccination: 0
Gender:Female  Submitted:2014-11-04, Days after onset: 1
Location:California  Entered:2014-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU5064AB1IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ238671IMRL
Administered by: Private     Purchased by: Private
Symptoms: Irritability
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: Fussy after vaccines given, TYLENOL given couple hours after.

VAERS ID:551990 (history)  Vaccinated:2014-10-27
Age:69.0  Onset:2014-10-27, Days after vaccination: 0
Gender:Male  Submitted:2014-10-30, Days after onset: 3
Location:Massachusetts  Entered:2014-11-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI89AD IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ498480IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site pain, Lethargy, Pain, Skin warm
SMQs:, Anaphylactic reaction (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Tues. became lethargic, felt like he had been stung by bees all over. In office 10/30 c/o pain Rt deltoid. Red, warm 7cm x 6cm area.

VAERS ID:554668 (history)  Vaccinated:2014-10-22
Age:81.0  Onset:2014-10-22, Days after vaccination: 0
Gender:Female  Submitted:2014-10-28, Days after onset: 6
Location:Massachusetts  Entered:2014-11-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~Td Adsorbed (no brand name)~UN~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ498480UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Headache, Injection site erythema, Injection site warmth, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Nausea, vomiting, fever, headache, body aches - 7" x 9" redness and warmth (L) deltoid-lasting 3-5 days.

VAERS ID:554670 (history)  Vaccinated:2014-11-03
Age:1.3  Onset:2014-11-04, Days after vaccination: 1
Gender:Male  Submitted:2014-11-04, Days after onset: 0
Location:Minnesota  Entered:2014-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)SANOFI PASTEURUI44AA3IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHJ498433IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Area on LVL is swollen, red and looks like about 50 cent in size. This is where the PREVNAR was given.

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